Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00237 | Date 24/09/2019 |
| Token No | SM/19-20/319 24/09/2019 | Serial | 028 |
| Patient Name | Miss MAMPI DEY SARKAR | Contact No | 9681050215 |
| Address | 71/G PATUA PARA LANE SERAMPORE 712201 | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | 5.4 cm |
| Diagnosis | |||